The High Court dismissed Janet Richardson’s appeal against a Financial Services Ombudsman finding that Irish Life Assurance plc was entitled to treat her late husband’s life insurance policy as void because medical information was not disclosed in the application.
The judgment, delivered by Mr Justice Hunt on 14 July 2016, reviewed the Ombudsman’s decision rather than rehearing the insurance complaint. The judge said the court’s task was to assess whether the decision was affected by a serious and significant error. He found that the investigation had been properly conducted and that the relevant facts were not in dispute.
Mr and Mrs Richardson applied for life cover in July 1996. Both answered “no” to questions asking whether they had received medical or psychiatric attention for an illness or injury in the previous five years, and whether they had undergone or been advised to undergo special investigations, tests or surgery. The policy began on 1 August 1996.
After Mr Richardson died in June 2013, his wife claimed the sum assured. Irish Life refused the claim, citing medical records that included treatment for alcohol excess in 1991, a hospital review for chest pain in 1994, and blood pressure, chest pain and liver test concerns recorded in 2003. The insurer said it would not have offered cover had the information been disclosed and offered to refund premiums paid.
Mrs Richardson told the Ombudsman that the 1991 attendance followed a weekend involving alcohol and required no further treatment. She said her husband’s 1994 chest pain followed a kick to the chest from a horse. She argued that he had not considered the events relevant and had not intended to mislead the insurer. The Ombudsman did not uphold her complaint in March 2015, finding that the application questions should have been answered “yes” and that the failure to disclose breached the duty of full disclosure.
On appeal, Mrs Richardson argued that the incidents were trivial, led to no particular diagnosis or follow-up treatment, and had not been deliberately withheld. The judge accepted that the non-disclosure was not wilful, deliberate or culpable. But he distinguished an earlier insurance case in which the proposal form limited answers to the proposer’s best knowledge: this form required answers to be “fully, correctly and truly” and did not contain that qualification.
The court concluded that the undisclosed information would have influenced a reasonably prudent insurer assessing the risk. It held that the Ombudsman’s finding was not tainted by serious error and dismissed the appeal. The judgment did not order payment of the claim.